Individual provider Active NPI

Brandon A West, DPM JD

  • Primary Podiatric Medicine Podiatrist
  • Walled Lake, MI
National Provider Identifier
1801080650
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
BW001378 Issued in MI
Practice address
1266 S Commerce Rd
Walled Lake, MI 48390-3008
Phone
(248) 624-1900
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X BW001378 MI Primary

Addresses

Primary practice location

1266 S Commerce Rd
Walled Lake, MI 48390-3008

Mailing address

21120 Constitution St
Southfield, MI 48076-5509
Phone (248) 624-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000602 MI Practitioner - Podiatry 1153214374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1266 S Commerce Rd
Walled Lake, MI 48390-3008
Phone (248) 624-1900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue74
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BW001378MIMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon a West DPM JD PLLC Primary Podiatric Medicine CurrentSince Feb 1, 2004 Accepting new patients

Locations

4771 Michigan Ave
Detroit, MI 48210
Phone (313) 897-2600

1266 S Commerce Rd
Walled Lake, MI 48390
Phone (248) 624-1900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1801080650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21120 CONSTITUTION ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765509",
            "telephone_number": "248-624-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 S COMMERCE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903008",
            "telephone_number": "248-624-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "BRANDON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM  JD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MI",
            "license": "BW001378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.